Provider Demographics
NPI:1598740573
Name:HERRICK, ROSEMARY ANNE (MA)
Entity Type:Individual
Prefix:MS
First Name:ROSEMARY
Middle Name:ANNE
Last Name:HERRICK
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 E STRATFORD AVE
Mailing Address - Street 2:SUITE 1-A
Mailing Address - City:LANSDOWNE
Mailing Address - State:PA
Mailing Address - Zip Code:19050-2042
Mailing Address - Country:US
Mailing Address - Phone:610-284-9293
Mailing Address - Fax:610-284-9293
Practice Address - Street 1:14 E STRATFORD AVE
Practice Address - Street 2:SUITE 1-A
Practice Address - City:LANSDOWNE
Practice Address - State:PA
Practice Address - Zip Code:19050-2042
Practice Address - Country:US
Practice Address - Phone:610-284-9293
Practice Address - Fax:610-284-9293
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS-007596-L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical